产后出血后发生肾功能不全的危险因素
An Analysis of Risk Factors of Renal Inadequacy after Postpartum Hemorrhage
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摘要: 目的 探讨产后出血后发生肾功能不全的危险因素.方法 根据产后出血的诊断标准, 回顾分析2010年1月至2014年12月发生产后出血并入住重症监护室的产妇病史资料200份.记录产妇的一般情况, 妊高症 (PIH) 及妊娠期糖尿病 (GDM) 病病史, ASA分级, 麻醉方式, 分娩方式, 产后出血量等指标.采用Logistic回归分析产后出血后发生肾功能不全的危险因素.结果 200例发生产后出血并入住重症监护室的产妇, 发生产后肾功能不全的21例 (10.5%) .年龄2044岁, 平均 (29.24±4.58) 岁;根据ASA评估标准评判患者术前情况, 其中ASA分级I级179例 (89.5%) , II级20例 (10.0%) , III级1例 (0.5%) , IV级0例.经阴道分娩147例 (73.5%) , 剖宫产53例 (26.5%) .椎管内麻醉 (含分娩镇痛) 196例 (98.0%) , 全身麻醉4例 (2.0%) .妊娠期间患有高血压疾病者12例 (6.0%) , 未患者188例 (94.0%) .有妊娠期糖尿病病史者9例 (4.5%) , 无妊娠期糖尿病病史者191例 (95.5%) .结论 年龄大于35岁, 剖宫产分娩, 妊娠期高血压病史及妊娠期糖尿病病史是产后出血后发生肾功能不全的危险因素.Abstract: Objective To investigate the risk factors of renal inadequacy after postpartum hemorrhage.Me thods According to the diagnostic criteria of postpartum hemorrhage, 200 cases of postpartum hemorrhage who were admitted to the Intensive Care Unit from January 2010 to December 2014 were collected. The general situation, history of pregnancy induced hypertension and gestational diabetes mellitus, ASA classification, anesthesia method, delivery mode, postpartum hemorrhage and other indicators. The risk factors were analyzed by logistic regression.Re s ults Among 200 cases of postpartum hemorrhage who were admitted in the intensive care unit, 21 cases with renal insufficiency were seenafter delivery (10.5%) aged between 20 and 44 years old with the average age of (29.24 ±4.58) years old. Using the ASA evaluation criteria to evaluate the preoperative situation, we observed179 cases in ASA grade level I (89.5%) , 20 casesin level II (10%) , one casein level III (0.5%) and no case in grade IV. Among all the women, we found 147 cases of vaginal delivery (73.5%) , 53 cases of cesarean section (26.5%) , 196 cases of spinal anesthesia (including labor analgesia) (98%) and 4 casesof general anesthesia (2%) . There were 12 patients with hypertension during pregnancy (6%) , and 188 patients without hypertension (94%) . There were 9 cases of gestational diabetes mellitus (4.5%) , and 191 patients without gestational diabetes mellitus (95.5%) .Conclus ions The risk factors of renal insufficiency after postpartum hemorrhage were: age older than 35 years, cesarean delivery, pregnancy history of hypertension or gestational diabetes mellitus.
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Key words:
- Postpartum hemorrhage /
- Renal inadequacy /
- Risk factor
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